Active NPI
Steven George Koenecke, RPH
- Pharmacist
- Wheat Ridge, CO
National Provider Identifier
1043505506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10144
- Practice address
- 5071 Kipling St
Wheat Ridge, CO 80033-2251 - Phone
- (303) 209-1849
- Fax
- (303) 209-1849
- NPI assigned
- Jun 13, 2011
- Last updated
- Jun 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10144 | CO | Primary |
Addresses
Primary practice location
5071 Kipling St
Wheat Ridge, CO 80033-2251
Mailing address
5071 Kipling St
Wheat Ridge, CO 80033-2251
Phone (303) 209-1849
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10144 | Other | CO | PHARMACY LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10144 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1043505506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5071 KIPLING ST",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800332251",
"telephone_number": "303-209-1849",
"fax_number": "303-209-1849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5071 KIPLING ST",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800332251",
"telephone_number": "303-209-1849",
"fax_number": "303-209-1849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENECKE",
"first_name": "STEVEN",
"middle_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-13",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "10144",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE NUMBER",
"identifier": "10144",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wheat Ridge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.